Standardising #surveillance of #hepatitis E virus #infection in the #EU/EEA: a review of national practices and suggestions for the way forward (J Clin Virol., abstract)

[Source: Journal of Clinical Virology, full page: (LINK). Abstract, edited.]

Journal of Clinical Virology / Available online 19 September 2019 / In Press, Journal Pre-proof

Standardising surveillance of hepatitis E virus infection in the EU/EEA: a review of national practices and suggestions for the way forward

Cornelia Adlhoch a, Zdenka Manďáková b, Steen Ethelberg c, Jevgenia Epštein d, Ruska Rimhanen-Finne e, Julie Figoni f, Sally A. Baylis g, Mirko Faber h, Kassiani Mellou i, Niamh Murphy j, Joanne O’Gorman j, Maria Elena Tosti k, Anna Rita Ciccaglione k, Agnetha Hofhuis l, Hans Zaaijer m, Heidi Lange n, Rita de Sousa o, Ana Avellón p, Lena Sundqvist q, Bengü Said r, Samreen Ijaz r

{a} European Centre for Disease Prevention and Control (ECDC), Gustav III:s boulevard 40, 169 73, Solna, Sweden; {b} National Institute of Public Health, Prague, Czech Republic; {c} Statens Serum Institut, Copenhagen, Denmark; {d} Health Board, Tallinn, Estonia; {e}
National Institute for Health and Welfare (THL), Helsinki, Finland; {f} Santé Publique France, Saint-Maurice, France; {g} Paul-Ehrlich-Institut (PEI), Langen, Germany; {h} Robert Koch-Institut, Berlin, Germany; {i} Hellenic Public Health Organization, Athens, Greece; {j} Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland; {k} Istituto Superiore di Sanità, Rome, Italy; {l} National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; {m}
Sanquin Blood Supply Foundation, Amsterdam, the Netherlands; {n} Norwegian Institute of Public Health, Oslo, Norway; {o} Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal; {p} Viral Hepatitis Reference and Research Laboratory National Center of Microbiology Carlos III Health Institute, Madrid, Spain; {q} The Public Health Agency of Sweden (Folkhalsomyndigheten), Stockholm, Sweden; {r} Public Health England, London, United Kingdom

Received 3 July 2019, Revised 5 September 2019, Accepted 11 September 2019, Available online 19 September 2019.

DOI: https://doi.org/10.1016/j.jcv.2019.09.005

 

Highlights

  • Experts suggest primary objectives for national HEV surveillance in EU/EEA countries:
    • to monitor the incidence of acute HEV cases
    • to monitor chronic HEV infections
    • to describe the epidemiology of acute and chronic HEV infections
  • Suggested secondary objectives for national HEV surveillance in EU/EEA countries:
    • to monitor HEV phylotypes/subtypes
    • to identify potential clusters/outbreaks
    • to collect information on possible routes of transmission
  • Overall, the majority of EU/EEA countries collect the suggested data and meet the outlined requirements to confirm an acute case.

 

Abstract

Background

Hepatitis E virus (HEV) infection is not notifiable at EU/EEA level, therefore surveillance relies on national policies only. Between 2005 and 2015, more than 20,000 cases were reported in EU/EEA countries. HEV testing is established in 26 countries and 19 countries sequence HEV viruses.

Objective and study design

WHO’s European Action plan for viral hepatitis recommends harmonised surveillance objectives and case definitions. ECDC’s HEV expert group developed minimal and optimal criteria for national hepatitis E surveillance to support EU/EEA countries in enhancing their capacity and to harmonise methods.

Results

The experts agreed that the primary objectives of national surveillance for HEV infections should focus on the basic epidemiology of the disease: to monitor the incidence of acute cases and chronic infections. The secondary objectives should be to describe viral phylotypes or subtypes and to identify potential clusters/outbreaks and possible routes of transmission. Seventeen of 20 countries with existing surveillance systems collect the minimal data set required to describe the epidemiology of acute cases. Eleven countries test for chronic infections. Twelve countries collect data to identify potential clusters/outbreaks and information on possible routes of transmission.

Discussion

Overall, the majority of EU/EEA countries collect the suggested data and meet the outlined requirements to confirm an acute case.

Keywords: Hepatitis E virus – EU/EEA – surveillance – testing

© 2019 Published by Elsevier B.V.

Keywords: Hepatitis E; EU.

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Giuseppe Michieli

I am an Italian blogger, active since 2005 with main focus on emerging infectious diseases such as avian influenza, SARS, antibiotics resistance, and many other global Health issues. Other fields of interest are: climate change, global warming, geological and biological sciences. My activity consists mainly in collection and analysis of news, public services updates, confronting sources and making decision about what are the 'signals' of an impending crisis (an outbreak, for example). When a signal is detected, I follow traces during the entire course of an event. I started in 2005 my blog ''A TIME'S MEMORY'', now with more than 40,000 posts and 3 millions of web interactions. Subsequently I added an Italian Language blog, then discontinued because of very low traffic and interest. I contributed for seven years to a public forum (FluTrackers.com) in the midst of the Ebola epidemic in West Africa in 2014, I left the site to continue alone my data tracking job.